Graduate Medical Education Research Journal

Despite the increasing demand for more emphasis on patient-centered care and population health, healthcare leadership competency models incorporate minimal essential skills and strategies for effective community engagement. This dissertation used a sequential exploratory mixed-methods approach to gain a greater understanding of how Critical Access Hospital (CAH) Chief Executive Officer (CEO) in t…

Heterobifunctional compounds (HBCs) that recruit E3 ligases to induce targeted protein degradation have emerged as promising therapeutic agents for cancer. Current HBC screening strategies prioritize biochemical degradation assays over functional anti-cancer activity assays. This approach may miss compounds with modest target protein degradation yet significant biological activity via alternative…

Rural populations in the United States continue to experience persistent disparities in healthcare access, preventive care utilization, and health outcomes. Rurality is commonly operationalized using geographic classification systems such as Rural–Urban Commuting Area (RUCA) codes; however, these measures may not fully capture how individuals perceive, experience, and navigate rural life. This di…

The increasing accessibility of transcriptomic profiling has resulted in a surge of molecular pathway-based cancer subtyping in the last decade. Subtype-specific treatment and risk stratification have been demonstrated to improve survival rates and may allow for a more efficient allocation of resources. Pancreatic cancer (PaC), the third leading cause of cancer-related deaths in the United States…

Pediatric cancer, while relatively rare, is the number one cause of death by disease in children in the US. Five-year relative survival for pediatric cancers has improved overall to over 80%, but the same gains have not been observed among all populations, with noted disparities by race, ethnicity, and socioeconomic status. This dissertation uses data from the Louisiana Tumor Registry and Iowa Ca…

Pancreatic cancer, the third leading cause of cancer-related deaths in the United States, carries a dismal 5-year survival rate of ~13%. Oncogenic KRAS mutations drive >90% of pancreatic ductal adenocarcinoma cases, with KRASG12D, KRASG12V, and KRASG12R predominating. Canonical KRASG12D strongly activates PI3K-AKT signaling via direct p110α binding, which represses MHC class I (MHC-I) expression …

Trauma-informed care (TIC) research is gradually rising and has been recognized as a supportive and beneficial organizational approach for clients/patients and employees dealing with mental and emotional symptoms due to trauma. The overarching goal of this dissertation is to advance understanding of how trauma-informed care is implemented within child-serving organizations (CSOs) and how differen…

The persistent nurse shortage is forcing the health sector to think about the way care is provided, and teams collaborate. One model, the Care Pair Model (CPM), pairs registered nurses (RNs) with nursing assistants (NAs) to distribute responsibility and provide patient care in a timely manner and with the best quality. Even though the model encourages working together effectively, many nurses sti…

Medulloblastoma (MB) is the most common malignant brain tumor in children. Among its molecular subgroups, Group 3 MB (G3MB) is the most aggressive and linked to a high potential for metastasis, poor prognosis, and limited survival despite intensive multimodal therapy. Current treatments, which include maximal surgical removal followed by craniospinal irradiation (CSI) and chemotherapy, have impro…

Background: Undergraduate nursing students experience stressful clinical situations that may influence learning, emotional well-being, and practice readiness. Structured debriefing provides an avenue for reflective processing; however, variations in debriefing practices can reduce effectiveness. This program evaluation examined the effect of a faculty-developed, standardized eLearning debriefing …

This dissertation presents two complementary investigations: (1) androgen receptor (AR)-directed therapy in glioblastoma (GBM) and (2) therapeutic and nanoparticle-based strategies for cisplatin-induced acute kidney injury (AKI). The first study identifies AR as a therapeutically actionable target in GBM. Multi-platform analyses revealed elevated AR expression across transcriptional subtypes that…

Trauma, chronic tissue damage, and late-stage cancer diagnosis remain major clinical challenges, largely due to the absence of biomaterials that can simultaneously provide mechanical adaptability, biological compatibility, and minimally invasive deployment. Conventional approaches often rely on chemistry-driven functionality or rigid device architectures, which can limit performance across divers…

Background: Cancer treatments often result in side effects that impair mental, sensory, motor, and body system functions. The purpose of this capstone was to advocate for the use of occupational therapy (OT) for the cancer population by gaining advanced knowledge and experience at two sites: a local YMCA cancer survivorship program and an outpatient rehabilitation clinic. Method: At the outpatien…

Parkinson’s disease(PD), the second most common neurodegenerative disorder, is likely to become more prevalent as the average age of the population increases. Although there are several palliative therapies for PD, there are no clinically available disease-modifying treatments. It is reasonable to explore novel methods for targeting neuroinflammation and providing neuroprotection in PD. Here we s…

Pancreatic adenocarcinoma has a 13% 5-year survival rate and limited curative therapeutic options outside of surgical resection at an early stage. Recent studies have indicated that the few patients who live longer than 5 years with this disease have high-quality neoantigens: mutated cancer-specific proteins that are recognizable by the immune system. This has led to various approaches aimed at t…

Peripheral T-cell lymphoma (PTCL) includes a varied group of post-thymic T-cell neoplasms; 40% are designated as PTCL-not otherwise specified (PTCL-NOS) due to being unclassifiable within other PTCL entities. Because of this, cases that fall into this category are heterogenous and a specific pathogenic mechanism and treatment regimen is difficult to elucidate. We identified two novel molecular su…

With greatly improved clinical outcomes in pediatric intestinal failure (PIF), the assessment of non-clinical, patient-reported outcomes (PROs) has become increasingly prioritized. One such outcome is patient quality of life (QoL). A growing body of work has investigated PIF patient QoL using generic assessment tools, such as the PedsQL, which measures patients’ health-related functioning. While …

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, with a five-year survival rate of only 13%. Tumor-promoting inflammation and immune evasion are hallmarks that contribute to tumor survival, proliferation, and metastasis and are driven by infiltrating leukocytes and the release of pro-inflammatory cytokines into the tumor microenvironment. Among the infiltrating…

Alzheimer’s disease (AD), Parkinson’s disease (PD), and colorectal cancer (CRC) remain significant clinical challenges requiring improved therapeutic strategies. This dissertation describes the design, synthesis, and pharmacological evaluation of structurally diverse small-molecule scaffolds targeting the sigma-1 receptor (S1R) for symptomatic modulation in AD, the dopamine D4 receptor (D4R) for …

Alzheimer’s disease (AD) is often considered a disease of old age, but new evidence suggests that modifiable lifestyle factors may impact disease processes long before clinical symptoms appear. Physical activity and fitness (PAF) are modifiable factors that are essential for brain health and cognitive function throughout the lifespan, from early childhood to late adulthood. PAF may influence the …